甲钴胺和谷胱甘肽预防奥沙利铂所致神经毒性的效果分析

Assessment of protective effect of mecobalamin and glutathione on oxaliplatin-induced neurotoxicity

  • 摘要: 目的:评估甲钴胺和还原性谷胱甘肽对减少奥沙利铂(L-OHP)引起的神经毒性的作用。方法采用随机、安慰剂对照的方法,将接受含有 L-OHP 和氟尿嘧啶(5-Fu)方案化疗的96例大肠癌患者随机分为对照组、甲钴胺组、还原性谷胱甘肽组,分别同时给予生理盐水、甲钴胺和还原性谷胱甘肽,利用奥沙利铂专用神经毒性分级和神经症状评分(NSS)指标观察患者神经毒性发生率及严重程度。结果对照组、甲钴胺组、还原性谷胱甘肽组急性神经毒性分别:28例(90.3%)、14例(46.7%)、19例(59.4%)。化疗3周期和6周期时,甲钴胺组神经毒性Ⅱ~Ⅲ度发生率显著低于对照组(P <0.01,P <0.05),而还原性谷胱甘肽组神经毒性Ⅱ~Ⅲ度发生率低于与对照组,但无显著性差异(P >0.05),甲钴胺组神经毒性Ⅱ~Ⅲ度发生率低于还原性谷胱甘肽组,但无显著性差异(P >0.05)。化疗3周期和6周期时,甲钴胺组 NSS 评分显著均低于对照组和还原性谷胱甘肽组(P <0.05或 P <0.01),而还原性谷胱甘肽组均与对照组无显著性差异(P >0.05)。结论甲钴胺能预防 L-OHP 神经毒性的发生率和程度。

     

    Abstract: Objective To assess the efficacy of mecobalamin and glutathione in preventing the neurotoxicity induced by oxaliplatin (L-OHP).Methods A randomized,placebo and control study was made ,in which 9 6 patients with colorectal cancer received L-OHP and 5-Fluorouracil (5-FU)was randomly divided into control group treated with normal saline,mecobalamin group with mecobalamin and glutathione group with glutathione,respectively,32 cases for each.Rate of neurotoxicity and severity was observed by L-OHP-specific neurotoxicity grading and neurological symptom score (NSS).Results Rates of neurotoxicity in control group,mecobalamin group and glutathione group were 90.3%(28 /32),46.7%(14 /32)and 59.4%(19 /32)respectively.After 3-cycle and 6-cycle chemotherapy,the rate of neurotoxicity in degree Ⅱ~Ⅲ was lower in mecobal-amin group than in other groups,but the differences were not significant (P >0.05),whereas NSS score was obviously lower in mecobalamin group than in other groups (P <0.05,P <0.01),but the difference between control group and glutathione group was not significant (P >0.05).Conclu-sion Mecobalamin can prevent the rate and severity of oxaliplatin-induced neurotoxicity.

     

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